Adverse effects for patients in big group practices

[摘要] All letters are subject to editing and may be shortened. General letters can be sent to bjgpdisc{at}rcgp.org.uk (please include your postal address for publication), and letters responding directly to BJGP articles can be submitted online via eLetters. We regret we cannot notify authors regarding publication.For submission instructions visit: bjgp.org/lettersPeter Edwards’ letter in your September issue is important.1 It is an irony that NHS policy continues to encourage GPs to form ever larger practices when the evidence is clear that these provide less good access for patients who have significantly lower satisfaction with them.In addition, there is a third important feature of general practice that also generally reduces in quality as list sizes increase — continuity of GP care. Indeed, this may be the mechanism through which patient satisfaction falls as there is a significant association between increasing list size and reduced continuity received by patients.2,3 The association between continuity and patient satisfaction has also been established, particularly when patient-reported measures of continuity are used.4Edwards describes Baker et al (1995)5 as a ‘seminal’ publication. We agree. In addition to reporting that patient satisfaction was lower in bigger practices, they also first found that patients had greater satisfaction when their practice used personal lists.5 Personal lists are the only evidence-based way that GP continuity can now be preserved in bigger practices.© British Journal of General Practice 2022REFERENCES 1.↵Edwards PJ (2022) Bigger practices are associated with decreased satisfaction and perceptions of access. Br J Gen Pract, DOI: https://doi.org/10.3399/bjgp22X720521.

[学科分类] 卫生学